Healthcaresector has aggregated and integrated several subsections, within theeconomic system, to meet the therapeutic, protective, and therehabilitative needs of patients. However, the dynamic changes inindividuals’ lifestyles coupled with the changes in the economyhave necessitated total transformation of the healthcare system. Themanagerial sector has put in place several initiatives and strategiestowards meeting the challenges arising within this sector. Theapproaches taken are geared towards prevention of issues fromarising, maintaining the costs, and improving the quality of thecare. In this paper am going to describe the prevention initiatives,the cost maintenance strategies, and the impact these strategies haveon quality improvement.
Asthe saying goes, prevention is better than cure managers within thehealthcare fraternity are more concerned on how to prevent certaincases from arising. It is clear that some cases have become moreprevalent and are on the rise today. For instance, obesity has becomea common phenomenon in countries like the United States of America(Michelle, 2010). Obesity has been attributed to the changes in thesociety and the environment. However, genetic setup and the behaviorsof an individual also make them susceptible to the disease. Obesityhas been linked to chronic diseases like diabetes, blood pressure,heart diseases, and given types of cancers. The preventive initiativein this case and other cases in general, in the health care sector,has taken the approach in subsequent paragraphs.
First,the preventive initiative comes up with a case in which action shouldbe taken (Starr, 2011). Like in this case, the managers will ask,“Why is it necessary for us to deal with the issue?" such aninquiry makes the matter an agenda of contention. Answers to thequestion will depict the current and estimated impacts of the issue. Further, the Answers could also point at the possible outcomes incase the issue is attended to on time.
Thesecond step in the preventive initiative is the recognition of causalfactors and the points of intervention (Starr, 2011). It is onlythrough the understanding of the contributing factors that a clearpreventive scheme can be put in place. Tabled evidence provides aplatform for assessing the degree of certainty that a specific factoris directly linked to the issue under research. The evidence relieson quality research carried out using certified experiments topresent reliable and etiological linkage hence, preventing anybiased judgment that may arise from the use of observational studies.It is only after the identification that the managers can decidewhich area they should lay much emphasis on since not all factors canbe addressed directly.
Afteridentification, preventive initiatives try to solve the question ofhow and where the intervention is required (Starr, 2011). Here,strategies are formulated in a given framework basing on the evidencecollected. The strategies should consider all the opportunitieswithin the actions taken. This stage aims at creating a comprehensivesketch that addresses the wide series of opportunities forinvolvement. Current information and practices are incorporated withpast experiences in the plan. Systems are developed, policies put inplaces, and awareness is created on the matter. An ideal thing withinthis stage is the identification of the suitable method to approach.Like in the case of obesity, the panel may aim and concentrate at thetype of food and the intensity of physical actions in a certainpopulation.
Anotherstep in the preventive initiative is the evaluation on thepotentialities of the interventions. The step aims at finding out howeffectual will the interventions, while taking in consideration allfactors that may interfere with the process, like cost. It is,therefore, necessary that the data is collected from the populationand the economic departments to ensure that only viable measures areimplemented. Undeniably, this stage uses varied sources ofinformation. The panel should ensure that only interventions with ahigh probability are considered. Nevertheless, it is very difficultfor one intervention to produce desired results hence, the need tocreate balance and spread energy to combine the measures for qualityresults.
Thelast part is the selection of a range of programs, policies, andmeasures to be taken to prevent the case (Starr, 2011). The step,basing on the above steps, seeks to settle on which measures toimplement and finance. This is normally reached at a consensus amongthe stakeholders. For instance, a portfolio action may be adopted dueto its affordability and the high probability of it succeeding. Inmost cases expensive programs are usually rejected. The measureshould also promote equity and pose negligible side effects in theimplemented areas.
Costcontainment strategies in relation to quality improvement
Managersin the health sector have spent a good amount of time and energytrying to establish laws and passing budgets that target regulationas well as cutting down on medical expenditures. In most cases,these control measures have obvious and intended impacts on thehealth sector. My briefs bring out the new approaches taken tocontain costs and enhance efficiency in the in the sector.
Oneof the strategies taken is simplifying the administrative set up ofthe health institutions (Allen, 2011). The health sector hasstreamlined its functions to meet certain standards and adhere tocertain government regulations. The measure targets to reduce theamount used in administration and also face out of the inefficienciesthat always arise in cases of conflicting interests with certaingovernment regulations. The move has not only reduced expenses, buthas also increased quality and efficiency in the health sector.
Theperformance-based program is also another strategy that has beenadopted to cut down on costs (Katherine, 2013). In this case, healthproviders are paid in relation to their service delivery. The paymentprocess takes into consideration the pre-laid medical conditions andthe required efficiency levels. The measure targets medicalpractitioners who have been neglected for a long time without rewardsand yet are required to provide quality healthcare. Though this movehas little effect on the cost, it has highly motivated healthproviders to render quality services to the patients.
Stateshave also gone a step higher to prescribe drug negotiations andvolume buying of drugs (Teresa, 2014). Such states combine severalmethods to regulate the price of drugs. The measures may include butnot limited to purchasing of drugs that are mostly preferred,additional producers cost rebates, negotiating and purchasing fromseveral states, and venturing into scientific research to find outthe effectiveness of the drug. The objectives aim at cutting down, ingeneral, the state spending on drugs, but not on the individual. Themove has proven cost effective as the state saves almost 8- 12% ondrugs, and the quality is enhanced basing on the scientificcomparative study carried out that leads to preferred and certifieddrugs in the market.
Establishmentof medical homes is also another successful strategy (Ronen, 2012)such homes, literally, are structured to meet the challenges in thecontemporary medical field. The major challenge addressed is meagercoordination that arises from the complicated formalities,contradictory therapy solutions, uncalled for hospitalizations, andundesirable reactions that come along with certain drugs. The resultson spending vary some studies assert that there is saving whileother depict no general savings. However, it is clear that themedical homes have the potential of reducing such spending. The clearbenefit of this approach is the increased quality in medical care,reduced error on recommendations given, and enhanced accessibility tomedical services.
Takinginto consideration of the patient’s safety is also another strategyto cut down on costs. Statistics point out that errors made in thehealth facilities have resulted to 500000 to 1.5 million deathsannually in American hospitals (Teresa, 2014). It is projected thatabout $19.5 billion is spent to deal with issues arising from sucherrors. The expenditure burden goes higher when patients are injuredand even stay longer in hospitals. Measures like e-prescription,regulated health work settings, and immediate reporting of sucherrors have been implemented to maintain the patient safety.
Thefight against swindling and abusing of drugs has also reduced thecost of drugs (Allen, 2011). States could save up to billions in casefraud and abuse are totally faced out in the medical sector.Fraudulent claims have always led to great losses to the statehence, poor quality dispensation of services.
Fromthe description above, it is necessary for the healthcare sector toadopt the preventive initiative to curb certain issues that are boundto lead to chronic diseases like obesity. Managers should also adoptcontainment measures that address both cost and the quality ofservices rendered.
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Starr,P. (2011). TheTransformation of the American healthcare.Chicago: Chicago University Press.
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